Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Comparative Efficacy and Safety of Nirmatrelvir/Ritonavir and Molnupiravir for Covid-19: A Systematic Review and Meta-Analysis Publisher Pubmed



Amani B1 ; Akbarzadeh A2 ; Amani B1 ; Shabestan R2 ; Khorramnia S3 ; Navidi Z3 ; Rajabkhah K4 ; Kardanmoghadam V5
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Epidemiology, School of Health, Ilam University of Medical Sciences, Ilam, Iran
  2. 2. Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Anesthesiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  4. 4. Department of Curative Affairs, Ministry of Health and Medical Education, Tehran, Iran
  5. 5. Research Department, Deputy of Research and Technology, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Medical Virology Published:2023


Abstract

This study aimed to compare the efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) with molnupiravir in the treatment of coronavirus disease 2019 (COVID-19). To end this, PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar were systematically searched to collect relevant evidence up to February 15, 2023. The risk of bias was evaluated using the risk of bias in nonrandomized studies of interventions tool. Data were analyzed using Comprehensive Meta-Analysis software. Eighteen studies involving 57 659 patients were included in the meta-analysis. The meta-analysis showed a significant difference between nirmatrelvir/ritonavir and molnupiravir in terms of all-cause mortality rate (odds ratio [OR] = 0.54, 95% confidence interval [CI]: 0.44–0.67), all-cause hospitalization rate (OR = 0.61, 95% CI: 0.54–0.69), death or hospitalization rate (OR = 0.61, 95% CI: 0.38–0.99), and negative polymerase chain reaction conversion time (mean difference = −1.55, 95% CI: −1.74 to −1.37). However, no significant difference was observed between the two groups in terms of COVID-19 rebound (OR = 0.87, 95% CI: 0.71–1.07). In terms of safety, although the incidence of any adverse events was higher in the nirmatrelvir/ritonavir group (OR = 2.52, 95% CI: 1.57–4.06), no significant difference was observed between the two treatments in terms of adverse events leading to treatment discontinuation (OR = 1.18, 95% CI: 0.69–2.00). The present meta-analysis demonstrated the significant superiority of nirmatrelvir/ritonavir over molnupiravir in improving clinical efficacy in COVID-19 patients during the prevalence of Omicron variant. These findings, however, need to be further confirmed. © 2023 Wiley Periodicals LLC.